Aim:This study aims to analyze the complications associated with Percutaneous Nephrolithotomy (PCNL) performed under Spinal Anesthesia Block (SAB) using a retrospective descriptive design. Material and Methods:This retrospective study included 100 patients who underwent PCNL under SAB from January 2020 to May 2023. Data were collected from medical records, including demographics, stone characteristics, anesthesia details, operative data, and post-operative outcomes. Complications were graded using the Clavien-Dindo Classification System, and statistical analysis was performed using SPSS version 25.0, with a p-value <0.05 considered statistically significant. Results:The mean age was 47.5 ± 11.8 years, and 60% were male. The mean BMI was 25.8 ± 3.4 kg/m², and comorbidities were present in 32% of patients. The mean stone size was 18.4 ± 4.7 mm, with upper pole stones being most common (38%). The mean surgery duration was 88.2 ± 15.6 minutes, and blood loss was 150.6 ± 30.5 mL. Post-operative complications occurred in 28% of patients, with Grade I (12%) and Grade II (10%) being most frequent. Regression analysis revealed age, BMI, stone size, surgery duration, blood loss, and comorbidities as significant predictors of complications (R² = 0.62, p < 0.001). Conclusion:PCNL under SAB is a safe and effective procedure, with most complications being minor and manageable. Predictive factors for complications include age, BMI, stone size, surgery duration, blood loss, and comorbidities, emphasizing the importance of thorough preoperative assessment, intraoperative vigilance, and postoperative care to optimize outcomes.